Future Directions of Credentialing Research in Nursing Workshop Summary (2015) / Chapter Skim
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3 Strengthening Data and Health Informatics for Credentialing Research
3 Strengthening Data and Health Informatics for Credentialing Research
Pages 27-40
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From page 27... ...
. To better understand the impact of nurse certification or nursing credentialing on different outcomes, researchers must have access to current, standardized, and interoperable data sets (Hughes et al., 2014)
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From page 28... ...
Electronic health records (EHRs) may permit closer analysis of the care process, but Hughes again cautioned that the number of health care providers who interact with a patient during a care visit or inpatient episode make attribution of outcomes to a specific person, whether credentialed or not, next-to-impossible.
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From page 29... ...
To answer questions about what credentials and characteristics make a difference in health care provision and health outcomes, systems need structured data that are coded using a standardized terminology and can be electronically exchanged across systems. Many barriers exist to optimizing interoperability among data systems.
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Developing a common data model will require the input of large groups of stakeholders to determine relevant data elements. Adopting a big data approach may be useful to help focus research questions and identify relevant metrics and variables based on the Expanded Conceptual Model (see Figure 2-2)
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• Where does this information sit in the m s measurement fr ramework? • Which data elements are needed to desc a n cribe the numer rator and de nominator?
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Nurses do not consistently document their interventions. This lack of adequate data, particularly nursing process and intervention data, in a structured coded format, hinders evaluation of the impact of nursing care on patient outcomes.
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The NDNQI RN Survey questionnaire collects data from RNs and advanced practice registered nurses (APRNs) with current certifications in a nursing specialty that is granted by a national nursing organization.
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Measure development is triggered by a variety of factors, including national policy issues, hospital requests, or from peer-reviewed publications on nursing processes or nurse-sensitive patient outcomes. Once a topic area is identified, the next step is to conduct literature reviews, looking for existing measures and guidelines (such as those endorsed by the NQF and the Agency for Healthcare Research and Quality [AHRQ]
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From page 35... ...
But achieving true patient-centered care requires expanding the focus of performance measurement or credentialing beyond the walls of a health care institution -- on the episode of health rather than the episode of health care provision. Brennan then urged the nursing credentialing community to weigh patient life experiences when considering which responsibilities that individual and organizational credentialing capture.
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From page 36... ...
Brennan suggested that some certification requirements may not adequately reflect the changing knowledge and skillsets required to practice in today's health care environment. For example, telemedicine encounters or remote nurse call centers may require different knowledge management experience, critical judgment, and interpersonal skills than acute care hospital settings.
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From page 37... ...
At present, researchers first specify the data they want and then try to find it in their health records and data systems, Dunton added, which requires a substantial amount of judgment and testing, and can thus affect reliability. Brennan suggested there was a need to think more broadly about necessary data elements and systematic sampling strategies to be more feasible.
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From page 38... ...
For example, public health nurses may work in a particular clinic, but be employed by a larger entity, such as county government. If there is an umbrella organization or a head nurse to pull information together, that may be a channel for obtaining certification information, Brennan concluded.
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From page 39... ...
2 This project has defined six competencies needed by nurses, so that they have the knowledge, skills, and attitudes required for improving the quality and safety of health care systems: patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety, and informatics (see Case Western Reserve University, 2014)
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